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Chapter 1
Triage
A Visit to the ER
"Hello Bruce, my name is Dr. Jeff Kirshner and I will be taking
care of you while you are in the hospital. We already know that you have a
serious blood disorder - It may or may not be leukemia.
If you want to hope for something, hope it is Leukemia because we
know how to treat Leukemia today. It
is not as serious a disease as it was in Brian Piccolo's day.
Right now our job is to get you through the night and we will nail down
the diagnosis tomorrow. You
are in desperate need of blood and platelets and the Syracuse Blood Bank
is out of your blood type. We
are waiting for your transfusions to come from Rochester and there is a
very real risk they may be closing the Thruway because of the blizzard.
"
Say again!
Was he talking to me? And what was this about not making it through
the night? Having driven the
New York State Thruway in a white out, I knew what it could be like.
I was desperately looking around for some help. My wife Sue was
looking at me with the same look she had on her face when our beloved
Tasha died in her arms.
Melissa’s look was not
much better. She was the
youngest of our three daughters and my partner in our computer business.
What was happening here? Hey,
wait just a minute - being sick was not part of my plan.
There was a business to run and somebody had to be in Albany
tomorrow to finish an installation.
My mind was in overdrive -
Why exactly would one wish for Leukemia of all things!
Leukemia kills people. I
had never been sick more than a day or two in my life.
Surrounded by my wife and one of our three daughters in a cramped
triage room at Community General Hospital, I began to worry about how they
would cope with me gone. -
For the first time in my life, my own mortality seemed very real; sure it
would happen some day - but in my 80's, not in my 50's.
I didn't know if I was in
heaven or hell, but something was definitely not right! I am the picture of health!
What was I doing here? Wow,
this must be serious, Sue called Fred and Melanie and they arrived within
24 hours. "Hi Dad, how are you feeling?" asked Melissa, my
partner in the web business. How was I feeling!
Like I had been run over by a freight train and left for dead! What in the world just happened to me?
My Dad died at 54 and my
mother at 63 so I had at least considered the possibility of a premature
death. But Dad was a three
pack a day smoker and I had recently endured a colonoscopy to head off the
colon cancer that prematurely claimed my mother.
Dad had Hodgkin’s
disease in his 30's back before chemotherapy and he once told me how
painful a Bone Marrow Biopsy was back then. My first biopsy to determine a
proper diagnosis and prognosis was scheduled for the next day.
What happens after
tonight? Will there even be a tomorrow? My life now depended on a courier
delivering a life saving parcel from Rochester - normally only an hour
away and it had already been over two hours.
Strangely enough, there was very little fear of death.
There was more concern over what would happen to Sue and our
family.
* * * * *
This concern for others
had not always been part of my personal agenda.
Over thirty years ago on an equally snowy day in Central New York,
Sue and I were married in a quaint little country church in Lafayette, NY.
We had only known each
other since July of the same year, but she stole my heart from the very
beginning. She declined two
of my proposals before finally relenting. From that moment on, my life as
a self-centered teen-ager came to an end.
A short time later, we
were living “on the economy” in the Cold War divided city of Berlin,
Germany. Our lives
quickly changed from that of blissful newly-weds to young, frightened
parents in a strange far-away land when Sue gave birth to the first of our
three daughters. Until then, responsibility had been only a vague term to
me. I suddenly found myself the breadwinner for our budding little family
of three.
My thoughts were bouncing
back and forth between previous life altering events and my present
predicament so fast I could barely keep things straight in my own mind.
I returned to that cold winter night in Berlin when our oldest
daughter, Michelle was born. The Air Force offered virtually no support to
married enlisted men back then. Busses
and the U-bahn subway were our only means of transportation, so a
neighbor’s car became our maternity transport.
That was the first time I
remember being in a hospital. Now,
nearly thirty years to the day later, frantic calls were going out to
Michelle and Melanie, our middle daughter.
Melissa lives close by and was at her Mother’s side as the doctor
delivered his frightening news.
My mind flashed to another
frantic event in the Pediatric Emergency Unit of the Upstate Medical
Center. Our middle daughter Melanie was strapped to a “papoose board”.
She had been locked in this position for several hours and was in a
full state of panic. Her boy friend, Adam was a year older and apparently had been
taken to the regular Emergency Room.
Melanie was crying because she was sure that Adam was dead.
The last she had seen him, he was unconscious, bleeding from his
head in his parent’s demolished car.
* * * * *
I returned to the present
and wondered who would take care of our little family.
They are all grown now and on their own, but once you become a
father, your concerns never really go away. Melissa and Sue are heavily
dependent on the website development business I had started after working
for a major corporation the last ten years.
We had invested well over
$100,000 of our savings to start the business and our net worth had
plummeted with the drop in tech stocks and the recession-mired economy.
Right now, however, we seemed to have a more pressing problem on
our hands than whether or not the DOW would recover.
My illness and the prospect of a premature death had now taken
center stage in our lives.
* * * * *
The courier completed his
life saving trip from Rochester to Syracuse in the middle of what was
hailed the "Storm of the Century".
The New York State Thruway had been closed but the driver somehow
managed to make the normally one hour drive in just under three hours in
time to save my life.
He arrived at 2:15 AM on
January 10, 2001 and the first of many life-saving transfusions was
administered. He delivered
one unit of platelets and two units of packed red blood cells. At the time
of my admission, my platelet count was just under 3,000, white blood cell
count was 1,500 and my hemoglobin was 9.
The normal counts for an average sized adult male are 300,000 for
platelets, 6,000 for white blood cells and 15 for hemoglobin.
I later learned that even
a small cut could have resulted in my death since the platelets were so
few in number. Such a small number of platelets would have been unable to
stop any significant bleeding and I would have literally bled to death
while waiting for help.
Platelets are the
components in our blood responsible for clotting. Red blood cells deliver
oxygen from the heart to the other organs of the body and return the
carbon dioxide to our heart for recycling. A normal adult has ten pints of
blood that circulate around the body in blood vessels that if fully
stretched could circle the earth two and one half times.
The Bone Marrow produces
between four and five billion Red Blood Cells or “Erythrocytes” per
hour and they last an average of four months.
The marrow produces White Blood Cells or “Lymphocytes” which
fight infection, Platelets or “Thrombocytes” that aid in clotting and
Plasma, which is the water and protein component of the blood.
In addition to the
concerns of blood loss and platelets, I began to understand why my stamina
had been so low for so long. It
was a significant effort to walk up a small flight of stairs because my
blood stream was unable to deliver the oxygen necessary to nourish my leg
muscles.
About two weeks prior I
had experienced a "fainting spell" in which my whole left side
went numb. At the time, I was carrying boxes up and down a long flight of
stairs in a dusty old warehouse in Batavia, NY.
It was a struggle, as I had to stop and grab the wall for support
about every seven steps. It
was a major sign of something seriously amiss with my health that I should
have acted on.
The building had
forty-foot high ceilings and smelled as though it had been a cold storage
warehouse in one of its previous lives.
It was now home to ARAmatic Refreshment Services, one of our best
customers. Fulfilling a
promise to Art Darrow, the owner, I was determined to get this, the fourth
of its four New York branches online before the end of the year.
Computers had been at the
center of my life long before most of the world knew input from output.
The first system I ever touched literally filled a room.
It was an IBM 360 with the unbelievable capacity of 64 kilobytes of
memory! We fed these funny little punch cards into a tray that
gobbled them up, sometimes quite literally so that you always wanted to
have an extra deck of JCL - Job Control Language
- available as your back up.
The machine would then
sputter and lights would flash and in an awesome display of power, it
would re-calculate the amount of money 1000’s of bank customers owed the
bank. A process that today could be done on my laptop in a matter of
seconds took most of an eight-hour shift.
I began my “real” work
life as a computer operator and then graduated to selling computers for a
now defunct company called Digital Equipment.
Computers like the one we sold for nearly one million dollars in
the eighties are now available at your local Radio Shack for just under
six hundred American dollars and they’ll probably throw in a web cam so
you can have a live videoconference with your grandchildren.
* * * * *
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